Insomnia: Therapeutic Approach

, MD, , MD, , Department of Psychiatry and Behavioral Medicine, University of Louisville School of Medicine, Louisville, Ky

South Med J. 2001;94(9) 

In This Article

Key Points

Insomnias are common and have specific causes:

  • Seek to diagnose the exact cause of problems with sleep (eg, congestive heart failure, depression, sleep apnea, etc).

  • Avoiding alcohol and caffeine at night is helpful.

  • Treat all conditions that might impair sleep.

  • Use symptomatic pharmacotherapy for insomnia sparingly, after addressing the previous factors, and individualize medicinal choice to patient characteristics.

  • Avoid prescribing sedatives in patients prone to substance abuse; rather, select sedating antidepressants, gabapentin, and possibly antihistamines.

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